The trust has been able to identify and manage treatment more effectively of patients at risk of readmission within a 30 day period through outpatient attendance intelligence. Photograph: Christopher Thomond for the Guardian

Business intelligence tools can provide useful clinical and performance data, but this has not always translated into information that can be acted on to improve services. Typically NHS trusts struggle to integrate business intelligence from multiple sources in a meaningful and timely way.

Scarborough Acute NHS Trust was no exception but it has acted to integrate business intelligence from a number of systems to help address its previously poor mortality statistics.

"It was normal to have different versions of analysis done at different points in time and that can sometimes create a distorted view," says Manni Imiavan, head of information, directorate of finance and procurement at Scarborough Acute NHS Trust.

"It took so much time and by the time analysis was done it was almost always out of date," he adds.

The latest draft of the DH commissioning consultation Developing commissioning support: towards service excellence published in November identifies business intelligence as a significant issue. It concludes: "Business intelligence should be provided from a small number of units. There is a range of business intelligence functions that could be standardised and scaled up."

Scarborough had a typical NHS setup with a number of different systems including the patient administration system (PAS) – including an operating room management information system, a system for maternity services and the clinical radiology information system. It was crucial to pull together the data from all of these systems to create a single picture of what was going on within the trust.

"We can now plug into all these data sources, get data in as real time as possible, and present it in a meaningful cohesive way," says Imiavan.

The trust used a Microsoft data warehouse tool but after searching around decided on a business intelligence tool called QlikView that was more "simple and intuitive".

QlikView works mainly with data held in the data warehouse. Where that is not possible it plugs in directly to the individual business intelligence system but the trust is working on feeding all data into the data warehouse.

"We spent under £40,000 which has been a very good investment in terms of a business intelligence tool," says Imiavan.

In 2009 Scarborough was the second worst in the country in the Dr Foster hospital standardised mortality ratio (HSMR) rankings. "Since then we have made a concerted move to improve things. One of the big contributions information has made is to support the consultants in monitoring mortality rates more effectively and take steps. There is still a lot of work to do but we think we are headed in the right direction," says Imiavan.

Pathology and outpatient attendance intelligence provide clinical teams with detailed information about the patients behind the numbers so they can investigate anomalies or outliers within the data.

The trust has also been able to use the business intelligence tool to tackle the readmission issue. "We have been able to identify those patients that are at risk of readmission and feed that information to the clinicians so they can manage the treatment of those patients. It is a more targeted approach to doing things that we didn't do enough before," says Imiavan.

Clinicians may plug into the tools from wherever they are across the multi-site hospital. Patient information is more easily disseminated, so issues around confidentiality had to be addressed.

"We were keen that the level of information that could identify a patient should only be made available to clinical teams and not managers," says Imiavan. The trust was able to anonymise certain data items so that only consultants can access them.

The tool also provides consultants with aggregate statistics about how they are performing in comparison to their peers nationally and locally.

The system has been extended to HR and finance. "While that data is not clinical it impacts on clinical performance. We need to know the skill mix within clinical teams," says Imiavan. In future there are plans to make the system available across the trust.

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